Antidepressant use in pregnancy

Introduction: Depression during pregnancy can affect up to 20% of all women and may be treated effectively with antidepressants. Currently, information on > 20,000 women exposed to antidepressants with pregnancy outcomes is available in the literature. However, there is a continuing fear of physicians prescribing and women taking these drugs during pregnancy, probably due to many of the studies reporting conflicting outcomes and subsequently, the dissemination of these results. Areas covered: The authors searched the literature using Medline, Embase and Reprotox followed by a manual search of retrieved articles and reviews of the topic. The authors then selected key publications in this field which they considered relevant to the subsequent discussion of this topic. Expert opinion: In this review, the authors evaluate the safety of different classes of antidepressants and find no convincing evidence of an increased risk for any adverse outcomes in an appreciable fashion. The authors note that even in studies documenting a potential for harm, the risk is marginal with rarely an odds ratio above 2. Therefore, it is important that each woman discusses the risks/benefits of treatment with her healthcare provider to allow an informed decision to be made based on scientific evidence.